Certain high-risk patients are excluded by current guidelines which could be complemented by including personalized fat z-scores LINKÖPING, Sweden, March 14, 2024
In a clinical landscape where options for weight management are growing rapidly, and the response to obesity treatments is as variable as obesity is heterogeneous, better ways of describing each patient's obesity phenotype are needed. Fat z-scores reveal the fat distribution pattern by describing whether a patient has stored less or more visceral-, subcutaneous-, and liver fat than what is expected from their BMI, and help to further understand obesity heterogeneity and optimal treatment strategies.
The personalized fat z-scores were introduced through research published in 2023 linking fat distribution patterns as described by the z-scores to specific cardiometabolic disease risk profiles in general population. The current study focused on obesity specifically and investigated cardiovascular disease (CVD) and type 2 diabetes (T2D) risk according to low, normal, and high z-score levels in 6,712 UK Biobank participants with obesity class I & II. An increased visceral fat z-score was the strongest predictor for both incident CVD and T2D: The average 5-year incidence rate of T2D was 2.8 times higher in those with a high versus low z-score – for CVD, it was 1.7 times higher (15.3% versus 9.1%). Notably, participants with obesity class I & II and high visceral fat z-score (observed in 30% of the participants) had a significantly higher average 5-year incidence rate of CVD than what was observed for participants with obesity class III (9.5%).
The study illustrates that personalized fat z-scores can be used to identify high- and low-risk individuals with obesity independent of BMI and provides a framework that may be used to describe differential response to obesity treatments.
Torsten Olbers, Professor of Metabolic surgery at Linköping University commented: "We really need tools to help us predict the need of treatment for the individual patient (i.e., precision medicine) when currently having a range of interventions for obesity (medications and surgery)."
Read the full publication titled 'Risk stratification using MRI-derived, personalized visceral-, subcutaneous-, and liver fat z-score in persons with obesity' here.
Read the publication introducing the fat z-score concept and the associated news release here.
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